Eugene J. Caragee, MD, an orthopedic surgeon at the Stanford University School of Medicine, said that his research has not shown that the more complex surgery is better for patients with simple stenosis. The procedure combines traditional stenosis therapy with other procedures that fuse the vertebrae. Nearly 1.2 million Americans have lumbar stenosis, according to the article, and that number is expected to reach at least 2.5 million by 2020.
A recent study of Medicare patients published in the Journal of the American Medical Association found the rate of traditional decompression surgery for stenosis declined slightly between 2002 and 2007, but the rate of complex surgery rose during that period by 15-fold. The study also showed the rate of complex procedures increased hospital costs for surgery by 40 percent. The complication rate for those cases was 5.6 percent, compared to 2.3 percent for the decompression surgery.
According to the report, patients undergoing the complex surgery cost an average of $80,888 per patient, compared with $23,724 for the decompression surgery. Richard Deyo, MD, of Oregon Health & Science University in Portland and lead author of the study, suggested that many factors play into the increase, including that “there are some prominent surgeons who have strong financial connections to device manufacturers.”
However, Chris Bono, MD, an orthopedic surgeon at Brigham and Women’s Hospital in Boston, says there are several other reasons for the increase, such as “better corrections of deformities.”
“The decision to do a more complex fusion versus a less complex fusion comes down to the surgeon’s preference,” Dr. Bono said in the report.
Read the Wall Street Journal report on surgery for spinal stenosis.
Read other coverage on spine surgery:
– ISASS President Dr. Thomas Errico: Spinal Fusion Coverage Update
– Minnesota Insurers Resist Spinal Fusion Coverage
